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1588053151
BRANDON HENTKOWSKI
SALT LAKE CITY, UT
NPI
1588053151
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MI 2000010234)
Enumeration Date
2015-01-20
Last Update Date
2015-01-20
Business Address
-- BRANDON HENTKOWSKI ATC
590 S WAKARA WAY
SALT LAKE CITY, UT 84108-1200
Phone number: 801-587-7198
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Mailing Address
-- BRANDON HENTKOWSKI ATC
590 S WAKARA WAY
SALT LAKE CITY, UT 84108-1200
Phone number: 801-587-7198
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